title: Sudden sensorineural hearing loss: subclinical viral and toxoplasmosis infections as aetiology and how they alter the clinical course.
abstract: OBJECTIVE
  To explore in a prospective study the evidence of certain viral and toxoplasmosis infections in sudden sensorineural hearing loss (SSHL).
  
  
  METHODS
  84 consecutive patients with SSHL meeting certain criteria. All patients were assessed for specific IgM antibodies against cytomegalovirus, herpes simplex virus, toxoplasma and Epstein-Barr virus. All were treated with intravenous steroids and assigned to two groups: 76 IgM negative (NV group) and 8 IgM positive (no history of acute infection - V group).
  
  
  RESULTS
  The mean hearing level at presentation was 86.5 dB HL (median, 100) in the V group and 60.7 dB HL (median, 61) in the NV group. The difference was statistically significant (p = 0.003). The mean hearing level following treatment was 81.8 dB HL (median, 88) in the V group and 48.7 dB HL (median, 39) in the NV group. The difference was statistically significant (p = 0.004). There was a considerable improvement in hearing after treatment only in the NV group (p < 0.000001).
  
  
  CONCLUSIONS
  Recent subclinical viral or toxoplasmosis infections may be involved in the pathogenesis of SSHL (in approx. 10% of cases), suggesting that SSHL is not a single disease. When certain viruses or toxoplasmoses are involved, the hearing is much worse in comparison to patients with no such indication of infection. An alteration in treatment dosage or method of steroid administration may be needed in such cases.
authors.affiliation: Department of Otorhinolaryngology/Head and Neck Surgery, Hippokration University Hospital, Athens, Greece.
authors.forename: Dimitrios
authors.initials: D
authors.lastname: Kikidis
authors.forename: Thomas P
authors.initials: TP
authors.lastname: Nikolopoulos
authors.forename: Georgios
authors.initials: G
authors.lastname: Kampessis
authors.forename: Georgios
authors.initials: G
authors.lastname: Stamatiou
authors.forename: Aristeidis
authors.initials: A
authors.lastname: Chrysovergis
mesh_terms: D017668:Age of Onset; D000914:Antibodies, Viral / Q000097:blood; D003586:Cytomegalovirus Infections / Q000453:epidemiology / Q000276:immunology; D020031:Epstein-Barr Virus Infections / Q000453:epidemiology / Q000276:immunology; D006319:Hearing Loss, Sensorineural / Q000453:epidemiology / Q000469:parasitology / Q000821:virology; D006561:Herpes Simplex / Q000453:epidemiology / Q000276:immunology; D006801:Humans; D007075:Immunoglobulin M / Q000097:blood; D015994:Incidence; D008875:Middle Aged; D011379:Prognosis; D011446:Prospective Studies; D016036:Seroepidemiologic Studies; D014123:Toxoplasmosis / Q000453:epidemiology* / Q000276:immunology; D014777:Virus Diseases / Q000453:epidemiology* / Q000276:immunology
chemical_list: D000914:Antibodies, Viral; D007075:Immunoglobulin M